Objective: To investigate the trend in incidence of hepatitis C in Jingzhou City, Hubei Province from 2008 to 2022, and to examine the age-period-cohort effect, so as to provide the basis for the formulation of hepatitis C prevention strategies. Methods: Demographic data and incidence data of hepatitis C in Jingzhou City from 2008 to 2022 were collected through the Chinese Disease Prevention and Control Information System, and the trend in incidence of hepatitis C was analyzed using average annual percent change (AAPC) and annual percent change (APC). The effects of age, period and cohort on the incidence of hepatitis C were examined with an age-period-cohort model. Results: The average annual incidence of hepatitis C in Jingzhou City from 2008 and 2022 was 20.26/105, with a male incidence of 20.04/105 and a female incidence of 20.47/105. The incidence of hepatitis C initially rose and then fell (AAPC=5.375%, P<0.05), with a rising trend from 2008 to 2018 (APC=13.370%, P<0.05) and a decreasing trend from 2018 to 2022 (APC=-12.231%, P<0.05). The incidence of hepatitis C appeared a tendency towards a rise with age, and the 80-84 age group had the highest risk (RR=11.420, 95%CI: 7.631-17.090) in relative to the 45-49 age group. The incidence of hepatitis C appeared a tendency towards a rise followed by a decline with time, and an increased risk of hepatitis C was seen from 2013 to 2017 (RR=1.393, 95%CI: 1.272-1.525) and a decreased risk was seen from 2018 to 2022 (RR=1.237, 95%CI: 1.072-1.428) in relative to the period from 2008 to 2012. The incidence of hepatitis C appeared a tendency towards a rise followed by a decline with the cohort, and a higher risk was found in the 1965-1984 cohort (all RR>1.300) in relative to the 1960-1964 cohort. The incidence of hepatitis C, the age and period effects in men and women, and the cohort effects in men were consistent with the whole population. In addition to the 1965-1984 cohort, a higher risk was found in the 2000-2014 cohort in women (all RR>1.250). Conclusions From 2008 to 2022, the incidence of hepatitis C in Jingzhou City experienced a notable rise and subsequent decline. The incidence of hepatitis C increased with age, with higher risks seen among middle-aged and elderly people.

Objective: To investigate the characteristics of dead HIV/AIDS cases within 1 year after confirmatory testing in Jingzhou City, Hubei Province from 1996 to 2021, so as to provide the evidence for facilitating early identification and treatment of AIDS. Methods: The basic and follow-up data of HIV/AIDS cases were retrieved from the HIV/AIDS Comprehensive Response Information System of Chinese Disease Prevention and Control Information System, and mortality density and its trend were evaluated within 1 year after confirmatory testing. The factors affecting death within 1 year after confirmatory testing were identified using a Cox proportional hazards model, and the demographics, detection, treatment and cause of death were analyzed among dead HIV/AIDS cases within 1 year after confirmatory testing. Results: A total of 3 304 HIV/AIDS cases were included, with 508 deaths within 1 year after confirmatory testing. The overall mortality density was 17.43 per 100 person-years, and the mortality density appeared a tendency towards a reduction from 1996 to 2021 (χ2trend=21.053, P<0.001). Of all dead HIV/AIDS cases within 1 year after confirmatory testing, 77.76% were men, 67.72% at ages of 45 years and older, 83.86% with transmission by heterosexual contact, 83.66% identified in medical institutions, 62.20% without antiretroviral therapy, and 47.83% without detection of CD4+T cell count. Mortality that was not associated with AIDS was the predominant cause of death among dead HIV/AIDS cases within 1 year after confirmatory testing (58.86%). Age of 30 years and older (HR: 1.781-4.644, 95%CI: 1.073-7.784), identification in medical institutions (HR=2.130, 95%CI: 1.306-4.474), initial CD4+T cell count of <200 cells/μL (HR: 2.649-12.879, 95%CI: 1.669-19.189), no antiretroviral therapy (HR=7.945, 95%CI: 5.743-10.993) and initiation of antiretroviral therapy 4 to 12 months after confirmatory testing (HR=1.636, 95%CI: 1.005-2.662) resulted in a higher risk of mortality within 1 year after confirmatory testing. Conclusions The mortality density appeared a tendency towards a reduction among cases within 1 year after confirmatory testing in Jingzhou City from 1996 to 2021. Mortality within 1 year after confirmatory testing was associated with advanced age, heterosexual contact transmission, identification in medical institutions, low CD4+T cell counts, and delay or absence of antiretroviral therapy.

Objective:To analyze the case fatality rate of HIV/AIDS cases and influencing factors in Jingzhou.Methods:The data were retrieved from HIV/AIDS Comprehensive Response Information System and the cases diagnosed with HIV/AIDS in Jingzhou during 1996-2021 and aged 15 years or older were selected for the study. The death curve was drawn with Kaplan-Meier method, and Cox proportional-hazards model was used to identify influencing factors for death.Results:A total of 3 304 HIV/AIDS cases were followed up for 16 091.5 person-years, and 893 cases died, with a case fatality rate of 5.5/100 person-years. The cumulative case fatality rates of 1, 5 and 10 years were 15.4%, 25.0% and 34.6% respectively, the cumulative case fatality rates of 1, 5 and 10 years were 6.9%, 14.4% and 23.7% in the cases with access to antiretroviral therapy (ART), and 68.0%, 90.1% and 98.7% in the cases without access to ART. The results of Cox proportional hazards regression model showed that the risk for death was higher in those without access to ART than in those with access to ART (a HR=9.85, 95% CI: 8.19-11.85). The risk factors for death in those with access to ART included being men (a HR=1.64, 95% CI: 1.29-2.08), age ≥60 years old at diagnosis (a HR=3.52, 95% CI: 2.38-5.20), being infected by injecting drug use/others (a HR=2.38, 95% CI:1.30-4.34), being detected by medical institution (a HR=1.53, 95% CI: 1.11-2.11), CD4 +T lymphocytes(CD4) counts <50 cells/μl (a HR=2.58, 95% CI: 1.87-3.58). The protective factor for death was high education level (high school and technical secondary school: a HR=0.64,95% CI:0.46-0.90; college and above: a HR=0.42, 95% CI: 0.24-0.73). The risk factors for HIV/AIDS death in those without access to ART included older age at diagnosis (30-44 years old: a HR=2.32, 95% CI: 1.40-3.84; 45-59 years old:a HR=2.61, 95% CI: 1.59-4.27; ≥60 years old: a HR=3.31, 95% CI: 2.01-5.47), lower CD4 counts (<50 cells/μl: a HR=10.47, 95% CI: 6.47-16.56; 50-199 cells/μl: a HR=2.31, 95% CI: 1.08-4.94; 200-349 cells/μl: a HR=2.35, 95% CI: 1.46-3.79). Conclusions:The case fatality rate of HIV/AIDS was relatively high in Jingzhou from 1996 to 2021, the first CD4 counts, ART and age at diagnosis were the major factors affecting HIV/AIDS death, "Expanding testing" and "prompt treatment upon diagnosis" should be continued and enhanced to improve the efficacy of ART and HIV/AIDS case survival.